The nurse is testing the deep tendon reflexes of a 30-year-old ...

[big1devin]

The nurse is testing the deep tendon reflexes of a 30-year-old woman who is in the clinic for an annual physical examination. When striking the Achilles heel and quadriceps muscle, the nurse is unable to elicit a reflex.
 
  The nurse's next response should be to:
  a.
  Ask the patient to lock her fingers and pull.
  b.
  Complete the examination, and then test these reflexes again.
  c.
  Refer the patient to a specialist for further testing.
  d.
  Document these reflexes as 0 on a scale of 0 to 4+.

Question 2

The nurse places a key in the hand of a patient and he identifies it as a penny. What term would the nurse use to describe this finding?
 
  a. Extinction
  b. Astereognosis
  c. Graphesthesia
  d. Tactile discrimination

[jliusyl]

Answer to Question 1

ANS: A
Sometimes the reflex response fails to appear. Documenting the reflexes as absent is inappropriate this soon in the examination. The nurse should try to further encourage relaxation, varying the person's position or increasing the strength of the blow. Reinforcement is another technique to relax the muscles and enhance the response. The person should be asked to perform an isometric exercise in a muscle group somewhat away from the one being tested. For example, to enhance a patellar reflex, the person should be asked to lock the fingers together and pull.

Answer to Question 2

ANS: B
Stereognosis is the person's ability to recognize objects by feeling their forms, sizes, and weights. Astereognosis is an inability to identify objects correctly, and it occurs in sensory cortex lesions. Tactile discrimination tests fine touch. Extinction tests the person's ability to feel sensations on both sides of the body at the same point.